Correlation of Endoscopic Findings with Various <i>Helicobacter pylori</i> Tests among Dyspeptic Patients

Abstract

Background: Helicobacter pylori is the most common chronic bacterial infection, and a significant etiological factor in acid peptic diseases and gastric cancer. Dyspepsia is a common gastrointestinal disorder, and the most common indication for gastroscopy. Detection of H. pylori during endoscopy has become standard clinical practice. Elevated levels of inflammatory markers such as C-reactive protein (CRP), are associated with pathological changes, and hence give useful information for exact diagnosis and therapy. Objectives: To determine the relationship between endoscopic findings, highly sensitive C-reactive protein level (hs-CRP) and H. pylori infection among dyspeptic patients using serological tests, stool antigen for H. pylori and antral histology. Methods: This was a prospective study; patients with dyspepsia, who referred to Kurdistan Teaching Center of Gastroenterology & Hepatology in Sulaimani City were assessed, during the period of December 2012 to March 2014. They underwent gastroscopy, and biopsies were taken from the corpus and antral portions of antral portion for histopathological exam. Patients’ serum samples were tested for H. pylori infection using ELISA method to detect (IgG & IgA) anti-bodies and stool samples were examined using rapid immunoassay method to detect H. pylori antigens. hs-CRP was assessed using ELISA. Results: One hundred dyspeptic patients were included in the study. The mean age was 34.2 years and male comprised 54% of the study samples. The common findings in oesophagogastroduodenoscopy (OGD) examination were antral gastropathy (59%) and duodenal ulcer (21%). A statistically significant (P < 0.01) correlation was found between hs-CRP and H. pylori IgG and IgA levels (titer). There was a highly significant (P < 0.01) correlation between the level of H. pylori IgG and the endoscopic findings. The highest serum level of H. pylori IgG was found in duodenal ulcer and antral gastritis, (88.86 ± 42.0) and (70.05 ± 35.2) Au/ml, respectively. There was a highly significant correlation (P < 0.01) between endoscopic findings and H. pylori positive antral biopsy, in duodenal ulcer, antral gastritis and duodenitis was 100%, 94.9% and 75% respectively. Also duodenal ulcer and antral gastritis showed high mean and percentage but no significant differences in both H. pylori IgA and stool Antigen.